title: Effect of combined cataract surgery and ranibizumab injection in postoperative macular edema in nonproliferative diabetic retinopathy.
abstract: OBJECTIVE
  To evaluate whether intravitreal ranibizumab injection at cataract surgery prevents postoperative diabetic macular edema (PME) in patients with stable diabetic retinopathy without significant macular edema.
  
  
  METHODS
  Eighty patients with cataract, stable diabetic retinopathy, and no significant macular edema were randomized to a sham group (cataract surgery only) or a group undergoing cataract surgery plus intraoperative ranibizumab injection. Best-corrected visual acuities, central subfield thickness, and total macular volume were assessed at baseline and 1 week, 1, 3, and 6 months postoperatively by spectral domain optical coherence tomography. Clinically meaningful PME (central subfield thickness increase >60 μm relative to baseline) was computed.
  
  
  RESULTS
  The groups did not differ in baseline best-corrected visual acuity, central subfield thickness, and total macular volume. Compared with the ranibizumab injection group, the sham group had significantly larger central subfield thickness increases relative to baseline at 1 week and 1 month; larger total macular volume increases at all time points (P = 0.012, P = 0.005, P < 0.001, P < 0.001, P = 0.005, P = 0.017, respectively); higher PME frequency at 1 month (P = 0.019); and poorer best-corrected visual acuity improvement from baseline to 6 months after surgery (P = 0.046).
  
  
  CONCLUSIONS
  In patients with stable diabetic retinopathy without significant macular edema, intravitreal ranibizumab injection at cataract surgery may prevent the postoperative worsening of macular edema and may improve the final visual outcome without affecting safety.
authors.affiliation: *Department of Ophthalmology, College of Medicine, Chungbuk National University, Cheongju, Korea; †Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea; and ‡Department of Ophthalmology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea.
authors.forename: Ju Byung
authors.initials: JB
authors.lastname: Chae
authors.forename: Soo Geun
authors.initials: SG
authors.lastname: Joe
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Yang
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.forename: Kyung Rim
authors.initials: KR
authors.lastname: Sung
authors.forename: Jae Yong
authors.initials: JY
authors.lastname: Kim
authors.forename: June-Gone
authors.initials: JG
authors.lastname: Kim
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Yoon
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002386:Cataract / Q000150:complications*; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D000069579:Ranibizumab; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab